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New cardiac procedure lowers risk of infection, complications


Athens Banner-Herald (GA)

04-09-14

April 09--When Louise Condron found out she would be the first person in Athens to undergo a new heart procedure she said she wasn't worried.

The Bogart resident underwent a 60-minute procedure Monday in St. Mary's Cardiac Catheterization Laboratory and became the first in the Athens area to receive a Subcutaneous Implantable Defibrillator, or S-ICD. The miniature electronic device provides protection from sudden cardiac arrest while also leaving the heart and vasculature untouched.

Utilizing a pulse generator, the S-ICD System uses a subcutaneous electrode that detects when the heart's main pumping chambers develop a dangerous rhythm or stop beating altogether and delivers a powerful electrical shock that re-starts the heart.

The device was created by Boston Scientific and recently was approved by the FDA for general use. Only a handful of people have received S-ICD in Georgia.

Although relatively new, Athens Regional Medical Center will perform the same procedure on Thursday.

Condron became a candidate for the new device after complications of congestive heart failure sent her to St. Mary's Hospital last fall feeling weak and struggling to breathe. As part of her diagnosis and treatment, her primary cardiologist, Clay Chappell, conducted a cardiac catheterization study to look for blockages in her coronary arteries.

During the study, he found one small blockage and recognized that Condron's heart was dangerously weak and that she could be at high risk of fibrillation, a condition that causes the muscles of the ventricles in the heart to twitch or quiver without squeezing the chambers and pumping blood effectively.

She was referred to cardiologist John Layher, who suggested the S-ICD procedure.

In the past, patients like Condron would have gotten an implantable cardioverter defibrillator, known as ICD, which also restarts the heart by passing a powerful electric shock through it, but requires doctors to implant leads, or wires, into the heart.

"Once leads are in the heart they become scarred into place and if you ever have to remove them it's very dangerous," said cardiologist John Layher, who implanted Condron's S-ICD. "There's a 1 to 2 percent chance you'll die trying to remove them. Those leads have been the weak link in the ICD system because they sit in the blood stream and every time your heart beats the wire has to wiggle."

Layher likened the wiggling of the wire to unfolding a paper clip and bending it back and forth until it breaks.

"That's what happens with the leads," he explained. "They tend to fail over time. With S-ICD we have a lead that's not sitting in the heart or wiggling, it's just under the skin. That makes it more durable and we think it's going to be a longer lasting device with less complications."

Kent Nilsson, a cardiac electro-physiologist for Athens Regional Medical Center, agrees.

"The biggest complication in the traditional device is lead failures. The nice thing about the new system is that there's no lead in the heart, so it can't break," said Nilsson, who will perform the procedure for the first time at ARMC on Thursday. "There's also a lower risk of infection."

The S-ICD system also is good news for patients not eligible for the traditional ICD system, such as dialysis patients and patients that have current infections as a result of past devices, Nilsson said.

Condron was home resting on Tuesday and said, overall, she's happy with the procedure.

"I think everything is fine. It's painful, but not as much today as it was (Monday)," she said. "I think I'm recovering pretty fast."

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Follow faith, health and Blueprint reporter April Burkhart at www.facebook.com/AprilBurkhartABH.

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(c)2014 Athens Banner-Herald (Athens, Ga.)

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